Provider Demographics
NPI:1659943587
Name:RYCZEK, MACKENZIE VERONICA (DC)
Entity Type:Individual
Prefix:DR
First Name:MACKENZIE
Middle Name:VERONICA
Last Name:RYCZEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 E COUNTY LINE RD STE U
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-1076
Mailing Address - Country:US
Mailing Address - Phone:317-883-9420
Mailing Address - Fax:
Practice Address - Street 1:997 E COUNTY LINE RD STE U
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1076
Practice Address - Country:US
Practice Address - Phone:317-883-9420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003197A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor